Sean Ennis, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

300808 Issued in CA

Practice address

13931 Carroll Way Ste B
Tustin, CA 92780-1861

Phone

(714) 988-8120

Fax

(714) 988-8119

NPI assigned

Oct 5, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Action Potential LLCGroup PAC ID 1850605312, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Action Potential, LLC

  dba Action Potential

  • Physical Therapy Clinic/Center
  • Glen Mills, PA
  • NPI 1831478692
  Medicare reassignment Care Compare group NPD
• Coury & Buehler Physical Therapy, Inc.

  • Physical Therapist
  • Anaheim, CA
  • NPI 1891960258
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1518639855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 E IMPERIAL HWY STE 100",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928216735",
            "telephone_number": "714-256-5074",
            "fax_number": "714-256-0770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13931 CARROLL WAY STE B",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927801861",
            "telephone_number": "714-988-8120",
            "fax_number": "714-988-8119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "SEAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "300808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Empier of Care LLC
• Encompass Health Rehabilitation Hospital of Tustin, LLC (Encompass Health Rehabilitation Hospital of Tustin)
• Enhance Health Group, LLC
• Enhanced Dermatology of Orange County
• John Richard Ennen, D.C.
• Fareed Entezar
• Epinex Diagnostics Laboratories, Inc.
• Jeffrey G Erb, NMD
• Erkan Ereren, MD
• Erin Fraser Benesch, Inc

• Physical Therapist in Tustin, CA
• Providers in Tustin, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.